Association between tooth loss and medical costs related to stroke in healthy older adults aged over 75 years in <scp>J</scp>apan

Iwasaki, Masanori; Sato, Misuzu; Yoshihara, Akihiro; Ansai, Toshihiro; Miyazaki, Hideo

doi:10.1111/ggi.12687

Cited by 20 publications

(21 citation statements)

References 27 publications

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“…Socioeconomic factors, such as economic status and educational level, significantly affect health behaviors, including the use of medical institutions . In a study that examined the relationship between the number of teeth and the medical costs of stroke for those aged 80 years, income and education years did not show significant influences . Socioeconomic status is an important factor affecting various health conditions.…”

Section: Discussionmentioning

confidence: 99%

“…The 2016 Survey of Dental Disease in Japan found that people aged ≥75 years had lost an average of approximately 10 teeth, and approximately 30% had full dentures . As a decline in chewing function after the loss of many teeth affects both dietary habits and nutrition intake, tooth loss is receiving increasing attention as an important factor affecting systemic health, including lifestyle‐related diseases, such as cancer, diabetes and cardiovascular disease; these conditions not only compromise health, but also increase medical costs . Therefore, tooth loss might increase not only dental care costs, but also overall medical costs because of the effects of dental health on systemic health.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have reported close relationships between oral and systemic health status . However, information on the relationship between oral health status and medical costs is limited . As inpatient costs are higher than outpatient costs in an older population, any increase in hospitalization duration significantly increases total medical costs .…”

Section: Introductionmentioning

confidence: 99%

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Associations of number of teeth with medical costs and hospitalization duration in an older Japanese population

Saito

Shimazaki

Nonoyama

et al. 2019

Geriatrics Gerontology Int

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Aim Many studies have reported close relationships between oral and systemic health. We explored the association of the number of remaining teeth with medical costs and hospitalization duration in people aged 75 and 80 years. Methods Oral health examinations were carried out at dental clinics in 2014. Medical cost and hospitalization duration data for fiscal year 2015 were obtained from the Mie Prefecture health insurer. We analyzed the data of 4700 individuals who met our inclusion criteria: 2745 75‐year‐olds and 1955 80‐year‐olds. The effects of remaining tooth numbers on medical costs and hospitalization days were analyzed using a generalized linear model with log link adjustment for confounders. Results Total medical costs for all diseases were significantly higher in those with 20–27, 10–19 and 1–9 teeth, and in edentulous older individuals, compared with those with 28 teeth. Outpatient medical costs for diabetes were significantly higher in those with 20–27 and 1–9 teeth. Inpatient medical costs for digestive cancers were significantly higher in those with 10–19 and 1–9 teeth, and in edentulous older individuals. Hospitalization for digestive cancer was significantly longer in those with 20–27, 10–19 and 1–9 teeth, and in edentulous older individuals, than in those with 28 teeth. The number of teeth as a continuous variable was significantly inversely associated with medical costs for cerebrovascular disease and digestive cancer, and hospitalization days for digestive cancer. Conclusion Small numbers of teeth were associated with higher medical costs and longer hospital stays for older Japanese. Geriatr Gerontol Int 2019; 19: 335–341.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Associations of number of teeth with medical costs and hospitalization duration in an older Japanese population

Saito

Shimazaki

Nonoyama

et al. 2019

Geriatrics Gerontology Int

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“…Associations between the number of teeth and systemic diseases 14 or mortality 15 are also reported. Furthermore, according to many studies, elderly people with 20 or more teeth can maintain good physical and mental health and high QOL 16 .…”

Section: Number Of Teethmentioning

confidence: 98%

Surveillance and monitoring of oral health in elderly people

Miyazaki

Jones

Beltrán-Aguilar

2017

International Dental Journal

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Continued ageing of the global population is expected to pose significant challenges to maintaining optimum lifelong health in individuals and populations. Oral health is an essential element of general health and quality of life throughout an individual's life course, yet it is often neglected in integrated approaches to general health promotion. Surveillance and monitoring systems are essential for developing oral health policy and strategy at both national and community levels. As major oral diseases, dental caries and periodontal diseases are core indicators for surveillance at every stage of life. In addition, oral mucosal lesions and masticatory function are essential indicators, especially in an ageing population. The assessment of risk factors such as tobacco use, alcohol consumption or dietary habits (e.g., sugar intake) is also important for oral disease prevention. Although surveillance is conducted through clinical examinations (normative assessments), this method is becoming more difficult to use because of high costs and human resource shortages, even in high‐income countries. Alternative and less resource‐demanding approaches, such as self‐reported protocols, are therefore needed at the global level. The World Health Organization's (WHO) oral health surveillance and monitoring activities have evolved into the Oral Health STEPwise approach, which includes questionnaire surveys (Step 1) and clinical examinations (Step 2). Collaboration between international organisations such as the World Dental Federation (FDI), WHO and the International Association for Dental Research (IADR) is now needed to coordinate global oral health surveillance and monitoring systems.

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“…In addition, conservation of remaining teeth has been reported to provide several advantages in the older population, including decreased incidence of dementia, arterial sclerosis and cardiovascular mortality . The association between tooth loss and increased medical costs has also been reported in adults over 75 years of age in Japan …”

Section: Introductionmentioning

confidence: 99%

Loss of oral self‐care ability results in a higher risk of pneumonia in older inpatients: A prospective cohort study in a Japanese rural hospital

Fujiwara

Minakuchi

Uehara³

et al. 2019

Gerodontology

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Objectives To identify significant risk factors associated with incidence of mortality and pneumonia in whole‐community‐based older inpatients resident in Japanese rural region. Methods Patients older than 65 years admitted between 1 April and 15 April 2010 to a core hospital located in a rural region were exhaustively recruited, and incidence of mortality and pneumonia during the 32‐month follow‐up period were evaluated. Independent variables at baseline measurement included age, gender, body mass index, Charlson comorbidity index, functional dependency, oral self‐care ability index, number of remaining teeth, hyposalivation and nutritional status. Dependent variables were incidence of mortality and pneumonia. Survival and non‐pneumonia curves were drawn using Kaplan‐Meier analysis. Cox proportional hazards analysis was performed to identify the risk factors related to incidence of mortality and pneumonia. Results The survival rate of 46 patients (male/female: 11/35; mean age: 83.8 ± 6.8 years) was 52.1%, and the incidence of pneumonia was 60.9%. Malnutrition and gender (male) were identified as significant risk factors for mortality (odds ratio [OR]: 8.18 and 4.90; 95% confidence interval [CI]: 1.77‐37.3 and 1.50‐16.0; P < 0.01 and <0.01, respectively). Loss of oral self‐care ability and gender (male) were identified as significant risk factors for incidence of pneumonia (OR: 8.97 and 4.58; 95% CI: 1.70‐47.4 and 1.50‐14.0; P = 0.01 and <0.01, respectively). Conclusions Malnutrition and loss of oral self‐care ability were significant risk factors for incidence of mortality and pneumonia, respectively. In response, supplying nutrition with appropriate diet and personalised oral care might contribute to reduction in mortality and prevention of pneumonia.

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Association between tooth loss and medical costs related to stroke in healthy older adults aged over 75 years in Japan

Cited by 20 publications

References 27 publications

Associations of number of teeth with medical costs and hospitalization duration in an older Japanese population

Associations of number of teeth with medical costs and hospitalization duration in an older Japanese population

Surveillance and monitoring of oral health in elderly people

Loss of oral self‐care ability results in a higher risk of pneumonia in older inpatients: A prospective cohort study in a Japanese rural hospital

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